- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,326.70 / $17,433.30 / $30,677.50
| Facility | | $10,326.70 | $17,433.30 | $30,677.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,498.60 / $14,140.36 / $23,182.72
| Facility | | $9,498.60 | $14,140.36 | $23,182.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,243.90 / $16,069.20 / $22,188.69
| Facility | | $9,243.90 | $16,069.20 | $22,188.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,384.50 / $36,384.50 / $42,700.30
| Facility | | $36,384.50 | $36,384.50 | $42,700.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $15,192.93 / $21,701.36
| Facility | | $1,787.00 | $15,192.93 | $21,701.36 |